Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Resource Guide to Your Aetna Retiree Benefits
|
|
|
- Garry Bradford
- 5 years ago
- Views:
Transcription
1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2017 Resource Guide to Your Aetna Retiree Benefits
2 Telephone numbers and contact information Keeping track of the range of benefits programs Aetna provides can be a challenge. Use this guide to help you quickly find the benefits resources and information you need. The guide also details the information you will need to have available when you call or visit the websites. For general information, call Aetna Human Resources at AETNA-HR ( ), weekdays, 8 a.m. to 8 p.m. ET; or visit the Aetna Retiree Connection website at available 24 hours a day, seven days a week. The website exclusively serves Aetna retirees and employees who are on long-term disability (LTD) prior to January 1, 2017 and provides you with direct access to many of the sites below and also includes other up-to-date information. For information about Call/Online resource Call weekdays (except as Retiree Health General information about your retiree/ltd health plans Update your personal information, such as mailing address, marriage, divorce Request materials (forms, summaries of benefits, plan documents) Medical and dental deductions (billing) Report if your eligibility for Medicare has changed Report the death of a retiree/spouse Aetna Human Resources AETNA-HR ( ) Select the prompt for Pension or Retiree and LTD health benefits Your Benefits Resources TM 8 a.m. 8 p.m. ET Have your user ID and password handy when you call or use the website. Contact Information 3
3 For information about Call/Online resource Call weekdays (except as Medical How your medical plan works Dependent information ID cards Payment of medical claims Find preferred providers/ facilities Coordination of supplemental plans with your Aetna medical plan How to access your Health Savings Account (HSA) Check provider acceptance of Aetna Medicare Open plans Use the phone number of the plan you are enrolled in: Aetna One Premier Service Center Pre-Medicare Plans and Aetna Traditional Choice Indemnity Plan Aetna Medicare Member Services Aetna Medicare Plan (PPO/PPO with ESA) AETNA ( ) PayFlex Service Center a.m. 6 p.m. (your local time) 8 a.m. 6 p.m. (your local time) For assistance with your Aetna HSA, call 24 hours a day, 7 days a week. Have your member ID card handy when you call. Aetna Navigator Have your user ID and password handy when you use the website. 4 Contact Information
4 For information about Call/Online resource Call weekdays (except as Prescription Drugs Rx coverage questions Formulary questions (what drugs are and are not covered) Medicare Part D coverage Specialty drug coverage (what drugs are covered) Payment of Rx claims Denial of Rx claims Use the phone number of the plan you are enrolled in: Aetna One Premier Service Center Pre-Medicare Plans and Aetna Traditional Choice Indemnity Plan Aetna Medicare Member Services Aetna Medicare Rx Plus (PDP) and Aetna Medicare Rx Standard (PDP) AETNA ( ) Aetna Navigator 8 a.m. 6 p.m. (your local time) 8 a.m. 6 p.m. (your local time) Have your member ID card handy when you call. Have your user ID and password handy when you use the website. Contact Information 5
5 For information about Call/Online resource Call weekdays (except as Mail-Order Drugs How mail-order delivery works Receive up to a 90-day supply of certain drugs directly at your home address Order refills by mail, over the phone or online if you pay by check or credit card If you need to submit a new order for mail-order prescription drugs (as a first-time or returning user), call the Member Services number on your ID card and request a mail-order pharmacy order form Aetna Rx Home Delivery RX-AETNA ( ) Aetna Navigator 7 a.m. 11 p.m. ET, Monday Friday 8 a.m. 9:30 p.m. ET, Saturday 8 a.m. 6 p.m. ET, Sunday Note: Pharmacists are available 24 hours a day, 7 days a week, to answer questions and provide emergency assistance. Have your prescription number available when you call to reorder. Have your user ID and password handy when you use the website. Self-Injectable Drugs and Specialty Medications Dedicated team of patient care coordinators, pharmacists and registered nurses are available to address all therapy support needs Clinical representatives are also available 24 hours a day, 7 days a week to provide assistance Aetna Specialty Pharmacy ASRX ( ) TDD: a.m. 7 p.m. ET Have your member ID card handy when you call. 6 Contact Information
6 For information about Call/Online resource Call weekdays (except as Dental How your dental plan works Aetna One Premier Service Center a.m. 6 p.m. (your local time) Have your member ID card handy when you call. ID cards Find a preferred provider Payment of dental claims Aetna Navigator Have your user ID and password handy when you use the website. Denial of dental claims Life Insurance Confirmation of life insurance coverage Add or change a beneficiary Beneficiary information Report the death of a retiree Aetna Human Resources AETNA-HR ( ) Select the prompt for Pension or Retiree and LTD health benefits Your Benefits Resources 8 a.m. 8 p.m. ET Have your user ID and password handy when you call or use the website. Contact Information 7
7 For information about Call/Online resource Call weekdays (except as Aetna 401(k) Plan Check 401(k) account balance Manage investments (change elections, transfer funds, reallocate balances and rebalance account) Change beneficiary Withdraw money from the plan Repay loans and check outstanding balance Initiate rollovers Tools and forms available online Pension General information about Aetna s pension plan Commence your pension Validate/change beneficiary Payment/direct deposit information Deductions from pension check Change tax withholding Update your personal information/mailing address Request materials (forms, plan documents) Report the death of a retiree/spouse Aetna Human Resources AETNA-HR ( ) and select the 401(k) menu option for automated account information 24 hours a day, seven days a week. Weekdays, 8 a.m. to 8 p.m. ET, for a customer representative, excluding stock market holidays (Brokerage: 8:30 a.m. to 5:30 p.m.) Aetna Human Resources AETNA-HR ( ) Select the prompt for pension information Your Benefits Resources 8 a.m. 8 p.m. ET Have your Social Security number and Voya Financial PIN handy when you call or use the website. 8 a.m. 8 p.m. ET Have your user ID and password handy when you call or use the website. 8 Contact Information
8 For information about Call/Online resource Call weekdays (except as Equity-Based Awards and ESPP Shares View equity awards and Employee Stock Purchase Program shares (including grant expiration dates) online Transact shares History for tax reporting purposes 1099 information Online modeling, reports and statements available Long-Term Care Insurance (LTCI) For questions about a long-term care plan UBS Financial Services AETNA-HR ( ) Select the prompt For more options, and then Stock options or call UBS OneSource directly at: (toll-free) or aet Long-Term Care Genworth: (For questions about LTC plans purchased from Genworth) Prudential: (For Prudential LTC plans purchased between January 1, 2009 and June 30, 2013) Aetna: (For Aetna LTC plans purchased before January 1, 2009) 3 a.m. 11 p.m. ET Have your Social Security number and participant ID handy when you call. You also will be asked to answer two security questions. 7 a.m. 7 p.m. ET 8 a.m. 6 p.m. ET 9 a.m. 7 p.m. ET For the website: log-in ID is your Aetna ID (with preceding A). If you don t recall your Aetna ID, you may call UBS. PIN is the last four digits of your Social Security number (until you change it). Contact Information 9
9 For information about Call/Online resource Call weekdays (except as Life Insurance/ Pre-retirement Career agents life insurance Converted/ported coverage Paid-up life insurance Aetna Foundation Aetna Employee Giving Campaign Employee and retiree giving programs Aetna Life Service Center Ported Supplemental Term Life (option 9) Contact CyberGrants: /aetna/aero Select Need Support? and then select I still have a question. 8 a.m. 7 p.m. ET Have your Social Security number handy when you call. 8 a.m. 8 p.m. ET Aetna employee ID number, hire date, termination date, date of birth 10 Contact Information
10 Other helpful information, tools and resources Resource Call/Online resource Aetna Informed Health Line Gives plan members access to registered nurses, 24 hours a day, 7 days a week Aetna Navigator Online tool to help you manage your Aetna medical, dental and Rx plan, including: Find a doctor, pharmacy or facility Review claims Order medications Coverage & Benefits Price-A-Drug SM Estimate the cost of care Claim Appeals Medical and dental benefit appeals Appeals of self-insured medical and dental claim denials are reviewed by Aetna Life Insurance Company. For insured benefits, appeals are reviewed by the applicable insurance carrier. All other claim appeals Call the Member Services number on your ID card for the appeals address. Address other claim appeals to: ERISA Appeals Committee, REAG c/o Aetna Corporate Compensation and Benefits 151 Farmington Avenue Hartford, CT Have your user ID and password handy when you use the website. Other helpful information 11
11 Resource Call/Online resource Dental Plan Selection Tool Compare options for dental plans DocFind Search for doctors, dentists, pharmacies, hospitals, facilities and other health care professionals by inputting information such as your ZIP code, city or county and selecting the name of your Aetna plan. Medicare* General information about Medicare, 24 hours a day, 7 days a week * Please contact Aetna Medicare Member Services first for an issue related to your Aetna Medicare plans. Social Security General information about Social Security Social Security Handbook TTY: Type Social Security Handbook in the search bar, then choose the Social Security Handbook link. Have your user ID and password handy when you use the website. Have your user ID and password handy when you use the website. 12 Other helpful information
12 Non-Discrimination Notice Aetna complies with applicable Federal civil rights laws and does not discriminate, exclude or treat people differently based on their race, color, national origin, sex, age, or disability. Aetna provides free aids/services to people with disabilities and to people who need language assistance. If you need a qualified interpreter, written information in other formats, translation or other services, call If you believe we have failed to provide these services or otherwise discriminated based on a protected class noted above, you can also file a grievance with Civil Rights Coordinator by contacting: Civil Rights Coordinator P.O. Box Lexington, KY (CA HMO customers: PO Box 24030, Fresno, CA 93779) , TTY: 711 Fax: (CA HMO customers: ) CRCoordinator@aetna.com. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights Complaint Portal, available at or at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, or at , (TDD). Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company, Coventry Health Care plans and their affiliates (Aetna). Legal Notices 13
13 14 Legal notices Availability of Language Assistance Services
14 CCG AETNAHR-0278 (02/17) 2017 Aetna Inc.
2016 Resource Guide to Your Aetna Retiree Benefits
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2016 Resource Guide to Your Aetna Retiree Benefits Telephone numbers and contact information Keeping track of
2015 Resource Guide to Your Aetna Retiree Benefits
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2015 Resource Guide to Your Aetna Retiree Benefits Telephone numbers and contact information Keeping track of
2014 Resource Guide to Your Aetna Retiree Benefits
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2014 Resource Guide to Your Aetna Retiree Benefits Keeping track of the range of benefits programs Aetna provides
Summary of Benefits January 1, 2017 December 31, 2017
Pennsylvania Northeastern and West Virginia Pennsylvania BLUE RX PDP Summary of Benefits January 1, 2017 December 31, 2017 This booklet gives you a summary of what we cover and what you pay. It doesn t
Coverage Through Employer/Union name Grp# Last Name: First Name: Middle Initial: 9 F
PO Box 9178 Watertown, MA 02472 2019 Employer Group HMO Election Form Please contact Tufts Health Plan Medicare Preferred if you need information in another language or format (Braille). DATE STAMP Please
Humana Medicare Employer Plan
GHHHWTDEN_18_NMRHCA Humana Medicare Employer Plan Plans that go the extra mile MILE Humana Medicare Advantage At Humana, we help you understand the many aspects of Medicare and try to make your options
2017 Benefits Overview
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2017 Benefits Overview (Updated July 2017) January 2017 Welcome! We are very excited at the possibility of having
Summary of Benefits. Allwell Medicare (HMO) Bexar County, TX H Benefits effective January 1, 2018 H0062_18_2962SB_Accepted
2018 Summary of Benefits Bexar County, TX H0062 -- 001 Benefits effective January 1, 2018 H0062_18_2962SB_Accepted 09102017 This booklet provides you with a summary of what we cover and your cost-sharing.
Enhanced Rx $10/30/50 - $20/60/100 with $0 Pharmacy Deductible. Blue Shield of California
An independent member of the Blue Shield Association Enhanced Rx $10/30/50 - $20/60/100 with $0 Pharmacy Deductible Outpatient Prescription Drug Coverage (For groups of 101 and above) THIS DRUG COVERAGE
2018 CareOregon Advantage Star (HMO) Summary of Benefits
2018 Summary of Benefits For Oregon counties: Clackamas, Columbia, Multnomah and Washington H5859_1099_CO_3018v3 CMS ACCEPTED CAREOREGON ADVANTAGE STAR (HMO) (A Medicare Advantage Health Maintenance Organization
Please contact Sharp Health Plan if you need information in another language or format (Braille).
2019 Sharp Direct Advantage SM Basic (HMO) & Sharp Direct Advantage SM Premium (HMO) Enrollment Form Completing your enrollment is your first step to becoming a Sharp Direct Advantage Medicare member.
Summary of Benefits. Allwell Medicare Premier (HMO) Pinal County, Arizona H
2018 Summary of Benefits Allwell Medicare Premier (HMO) Pinal County, Arizona H0351 -- 043-004 Benefits effective January 1, 2018 H0351_18_3060SB_A_ Accepted 10142017 This booklet provides you with a summary
Prescription Drug Claim Form
Prescription Drug Claim Form This claim form is to be used for reimbursement on covered medications provided by pharmacies. The filing of this form does not guarantee reimbursement. Please consult your
2018 Summary of Benefits
2018 Summary of Benefits Benton, Crawford, Sebastian, Washington Counties, AR H9630--001 Benefits effective January 1, 2018 H9630_18_2913SB Accepted 09302017 This booklet provides you with a summary of
2019 Health Net Ruby Select (HMO) H0562:112 Fresno County, CA
2019 Health Net Ruby Select (HMO) H0562:112 Fresno County, CA H0562_19_7914SB_112_M_Accepted 09072018 1 This booklet provides you with a summary of what we cover and your cost-sharing responsibilities.
Summary of Benefits. Allwell Medicare (HMO) Palm Beach, Manatee, Marion and Seminole Counties, Florida H
2018 Summary of Benefits Palm Beach, Manatee, Marion and Seminole Counties, Florida H9276-003 Benefits effective January 1, 2018 H9276_18_2860SB_A Accepted 09172017 This booklet provides you with a summary
Summary of Benefits. Allwell Medicare (HMO) Cameron and Hidalgo counties, TX H
2018 Summary of Benefits Allwell Medicare (HMO) Cameron and Hidalgo counties, TX H0062 -- 003 Benefits effective January 1, 2018 H0062_18_2965SB_Accepted 09102017 This booklet provides you with a summary
2018 Summary of Benefits
2018 Summary of Benefits Hamilton, Howard, and Marion counties, Indiana H3499--001 Benefits effective January 1, 2018 H3499_18_3257SB_A Accepted 09172017 This booklet provides you with a summary of what
2018 Summary of Benefits
2018 Summary of Benefits Allwell Medicare Select (HMO) Benton, Washington counties, AR H9630--003 Benefits effective January 1, 2018 H9630_18_2915SB Accepted 09302017 This booklet provides you with a summary
Individual Enrollment Form
Please contact Peach State Health Plan if you need information in another language or format (Braille). To enroll in Peach State Health Plan, please provide the following information: Please check which
Health Options Program Option Selection Period FAQs
Health Options Program Option Selection Period FAQs The Health Options Program Q What is a Qualifying Event? A A Qualifying Event is what makes you eligible for enrollment in the Health Options Program.
Summary of Benefits. Tufts Medicare Preferred PDP PLANS Employer Group Tufts Medicare Preferred PDP3
Tufts Medicare Preferred PDP PLANS 2018 Summary of Benefits Employer Group Tufts Medicare Preferred PDP3 The benefit information provided is a summary of what we cover and that you pay. It does not list
Pharmacy Benefits Member Guide
Commercial Pharmacy Benefits Member Guide Optimizing your pharmacy benefits for a healthier you Carol Kim, Health Net We focus on getting you the health information you need, when you need it. Understanding
Summary of Benefits. Allwell Medicare Essentials II (HMO) Maricopa County, Arizona H
2018 Summary of Benefits Allwell Medicare Essentials II (HMO) Maricopa County, Arizona H0351 -- 049-001 Benefits effective January 1, 2018 H0351_18_3205SB_B_ Accepted 10142017 This booklet provides you
Participating Pharmacy 9 Non-Participating Pharmacy 7,8
Rx Spectrum $10/25/40 - $20/50/80 with $0 Pharmacy Deductible Outpatient Prescription Drug Coverage (For groups of 101 and above) Highlight: $0 Calendar Year Pharmacy Deductible $10 Tier 1 / $25 Tier 2
CarePartners of Connecticut HMO Plans Buyer s Guide. Includes a chart comparing all HMO plan options
CarePartners of Connecticut HMO Plans 2019 Buyer s Guide Includes a chart comparing all HMO plan options Service Area: to join a CarePartners of Connecticut plan, you must live in our service area: Hartford,
Summary of Benefits. Allwell Medicare (HMO) Duval, Lake, Pinellas, Polk and Volusia Counties, Florida H H9276_18_2858SB _A Accepted
2018 Summary of Benefits Duval, Lake, Pinellas, Polk and Volusia Counties, Florida H9276-001 Benefits effective January 1, 2018 H9276_18_2858SB _A Accepted 09172017 This booklet provides you with a summary
Please check which plan you want to enroll in: If you live in Litchfield, Hartford, New Haven, New London, Tolland, or Windham Counties: Sex: 9 M ( )
PO Box 9178 Watertown, MA 02472 2019 CarePartners of Connecticut (HMo) INDIVIDUAL ENROLLMENT FORM Please contact CarePartners of Connecticut if you need information in another language or format (Braille).
2017 Summary of Benefits
P.O. Box 52424, Phoenix, AZ 85072-2424 2017 Summary of Benefits Employer PDP sponsored by The Coca-Cola Company () A Medicare Prescription Drug Plan (PDP) offered by Insurance Company with a Medicare contract
Tufts Health Plan Tufts Medicare Preferred HMO Prime For Working-Aged Employees
Check if Complete Tufts Health Plan Tufts Medicare Preferred HMO Prime For Working-Aged Employees To ensure that your applications are processed as quickly as possible, just follow this checklist Employer
Alternate Phone Number: ( ) Address: Sex: 9 M ( ) 9 F. Permanent Residence Address (P.O. Box is not allowed): City: State: Zip Code:
PO Box 9178 Watertown, MA 02472 2018 TUFTS MEDICARE PREFERRED HMO INDIVIDUAL ENROLLMENT FORM Please contact Tufts Health Plan Medicare Preferred if you need information in another language or format (Braille).
Request for Redetermination of Medicare Prescription Drug Denial
Request for Redetermination of Medicare Prescription Drug Denial Because we, Allwell, denied your request for coverage of (or payment for) a prescription drug, you have the right to ask us for a redetermination
Summary of Benefits. Allwell Medicare Premier (HMO) Duval, Pinellas, Polk, Hernando, Pasco and Volusia Counties, Florida H
2018 Summary of Benefits Duval, Pinellas, Polk, Hernando, Pasco and Volusia Counties, Florida H9276-002 Benefits effective January 1, 2018 H9276_18_2859SB_B_Accepted 10032017 This booklet provides you
2017 Summary of Benefits
P.O. Box 52424, Phoenix, AZ 85072-2424 2017 Summary of Benefits Employer PDP sponsored by Shell () A Medicare Prescription Drug Plan (PDP) offered by Insurance Company with a Medicare contract January
9 HMO Basic Rx $23.00 per month 9 HMO Value Rx $54.00 per month 9 HMO Prime Rx $79.00 per month 9 HMO Prime Rx Plus $99.
PO Box 9178 Watertown, MA 02472 2019 TUFTS MEDICARE PREFERRED HMO INDIVIDUAL ENROLLMENT FORM Please contact Tufts Health Plan Medicare Preferred if you need information in another language or format (Braille).
Travel Tips. Health Net. for Stanford Students and their enrolled dependents
Health Net Travel Tips for Stanford Students and their enrolled dependents Kim Aung Health Net Wherever you go, Health Net Life Insurance Company (Health Net) has you covered Healthy travel packing list
Any missing information may cause a delay in processing your request.
Member Reimbursement Claim Form *3000* This form may be used for Allwell Medicare products. Important: Complete a separate Member Reimbursement Claim Form for each member asking for reimbursement for covered
NOTIFICATION FROM EMPLOYEE BENEFITS
NOTIFICATION FROM EMPLOYEE BENEFITS The Open Enrollment period will commence on November 1, 2017 and end on November 21, 2017. All changes made during this period will be effective January 1, 2018. If
2018 Summary of Benefits
2018 Summary of Benefits Barry, Christian, Greene, Jasper, Lawrence, and Newton Counties, MO H1664--001 Benefits effective January 1, 2018 H1664_18_2916SB Accepted 09302017 This booklet provides you with
Health Options Program
Pennsylvania Public School Employees Retirement System (PSERS) Health Options Program 2017 Annual Notice of Changes You are currently enrolled as a member of the Enhanced, Basic or Value Medicare Rx Option.
2019 Allwell Medicare (HMO) H Kane County, IL
2019 Allwell Medicare (HMO) H1475 -- 002 Kane County, IL H1475_19_7967SB_002_M Accepted 09282018 This booklet provides you with a summary of what we cover and your cost-sharing responsibilities. It does
Mail all medical claims to: or Mail all behavioral health claims to: Any missing information may cause a delay in processing your request.
Member Reimbursement Claim Form This form may be used for Health Net Medicare products. Important: Complete a separate Member Reimbursement Claim Form for each member asking for reimbursement for covered
2019 Health Net Gold Select (HMO) H0562: Riverside and San Bernardino Counties, CA
2019 Health Net Gold Select (HMO) H0562:101-002 Riverside and San Bernardino Counties, CA H0562_19_7860SB_101_002_M_Accepted 09072018 1 This booklet provides you with a summary of what we cover and your
REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION This form may be sent to us by mail or fax:
REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION This form may be sent to us by mail or fax: Address: Medicare Part D Prior Authorization Department P.O. Box 419069 Rancho Cordova, CA 95741
2019 Allwell Medicare (HMO) H7173: 002 Clayton, DeKalb, Fayette, Fulton, Gwinnett, Henry, and Rockdale Counties, GA
2019 Allwell Medicare (HMO) H7173: 002 Clayton, DeKalb, Fayette, Fulton, Gwinnett, Henry, and Rockdale Counties, GA H7173_19_8074SB_002_M Accepted 09072018 This booklet provides you with a summary of what
Prescription Drug Schedule Humana Medicare Employer Plan
PUB Name: GSB0012 2018 Prescription Drug Schedule Humana Medicare Employer Plan Rx 269 University of Richmond Y0040_GHHK48XEN18 (Pending CMS Approval) Rx 269 Let's talk about Humana Medicare Employer
Your 2015 Health Informational Meeting Health Care Focused on You
Your 2015 Health Informational Meeting Health Care Focused on You Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2 Agenda Introduction of Seton Health Alliance
2018 Summary of Benefits
2018 Summary of Benefits Ascension, East Baton Rouge, Livingston, West Baton Rouge, and Tangipahoa Parishes, LA H5117--001 Benefits effective January 1, 2018 H5117_18_2922SB Accepted 09302017 This booklet
Medicare Made Simple. A guide to your health plan options
Medicare Made Simple A guide to your health plan options Introduction When you re eligible for Medicare, understanding and comparing all of your health plan options can be confusing. This guide describes
2018 ConnectiCare SOLO. Individual plans
2018 ConnectiCare SOLO Individual plans Welcome to ConnectiCare This guide includes information about ConnectiCare s 2018 SOLO plans. We re pleased to offer you a range of plan options, giving you the
2019 Allwell Medicare (HMO) H2915: 005 Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Venango, and Warren Counties, PA
2019 Allwell Medicare (HMO) H2915: 005 Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Venango, and Warren Counties, PA H2915_19_8121SB_005_M Accepted 09072018 This booklet
2019 Allwell Medicare (HMO) H2915: 003 Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset,
2019 Allwell Medicare (HMO) H2915: 003 Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington, and Westmoreland Counties, PA H2915_19_8120SB_003_M
Annual Notice of Changes for 2018
Brand New Day Classic Choice for Medi-Medi (HMO) offered by Brand New Day Annual Notice of Changes for 2018 You are currently enrolled as a member of Classic Choice for Medi-Medi. Next year, there will
Annual Notice of Changes for 2018
Brand New Day Classic Care Drug Savings (HMO) offered by Brand New Day Annual Notice of Changes for 2018 You are currently enrolled as a member of Classic Care. Next year, there will be some changes to
Individual Enrollment Form
Please contact Sunshine Health Medicare Advantage if you need information in another language or format (Braille). To enroll in Sunshine Health Medicare Advantage, please provide the following information:
2019 Health Net Ruby (HMO) H Lane County, OR
2019 Health Net Ruby (HMO) H6815-003-003 Lane County, OR H6815_19_8067SB_003_003_M Accepted 09072018 This booklet provides you with a summary of what we cover and your cost-sharing responsibilities. It
Medical Benefits Claim Instructions
Medical Benefits Claim Instructions Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim
2018 Summary of Benefits
2018 Summary of Benefits Abbeville, Allendale, Bamberg, Barnwell, Chester, Chesterfield, Clarendon, Dillon, Edgefield, Florence, Georgetown, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg,
Sharp Advantage Employer Group Enrollment Form
2017-2018 Sharp Advantage Employer Group Enrollment Form To enroll in Sharp Advantage please provide the following information: Effective Date of Coverage: MM/DD/YY ( / 01 / ) Employer or Union Name: City
2019 Allwell Medicare (HMO) H0062: 002 Collin, Dallas, Denton, Rockwall, Smith and Tarrant counties, TX
2019 Allwell Medicare (HMO) H0062: 002 Collin, Dallas, Denton, Rockwall, Smith and Tarrant counties, TX H0062_19_7952SB_002_M_Accepted 09072018 This booklet provides you with a summary of what we cover
2019 Health Net Violet 2 (PPO) H Marion and Polk Counties, OR
2019 Health Net Violet 2 (PPO) H5439-014-003 Marion and Polk Counties, OR H5439_19_8049SB_014_003_M Accepted 09072018 This booklet provides you with a summary of what we cover and your cost-sharing responsibilities.
NEWS For Retirees Eligible for Premium Assistance Winter 2017
Pennsylvania Public School Employees Retirement System (PSERS) NEWS For Retirees Eligible for Premium Assistance Winter 2017 Protect Your Family; Document Your Health History Have you considered starting
Medicare Made Simple. A guide to your health plan options
Medicare Made Simple A guide to your health plan options Introduction When you re eligible for Medicare, comparing all of your health plan options can be confusing. The truth is, it doesn t have to be.
2019 SUMMARY OF BENEFITS
2019 SUMMARY OF BENEFITS Vitality Health Plan of California (HMO) County and County H1426 001/002/003 H1426_19_078_MK_ENG_M H1426 001/002/003 Vitality Health Plan of California January 1, 2019 December
2019 Short Enrollment Request
Page 1 of 7 Medicare Advantage HMO South Region 2019 Short Enrollment Request FOR OFFICE USE ONLY Member ID no. Effective date of coverage Election period individual is enrolling in: AEP SEP ICEP IEP OEPI
Medicare Advantage HMO plans
2018 Medicare Advantage HMO plans Promise Rx (HMO-POS) Surety Rx (HMO-POS) Medicare coverage that works with and for you Y0117_MC-778-2822-C-10-17 approved Why choose a plan from Security Health Plan?
Annual Notice of Changes for 2018
Brand New Day Harmony Choice for Medi-Medi (HMO SNP) offered by Brand New Day Annual Notice of Changes for 2018 You are currently enrolled as a member of Harmony - Dual Access. Next year, there will be
2018 Summary of Benefits
January 1 December 31, 2018 2018 Summary of Benefits Kaiser Permanente Medicare Advantage (HMO) for Federal Members High, Standard, and High Deductible Health Plan Options MA0001579-51-17 About this Summary
Plan Comparison Chart. Includes medical and prescription drug (Rx) benefit information
Medicare Advantage (HMO) Plans 2019 Plan Comparison Chart Includes medical and prescription drug () benefit information Plan Comparison Chart HMO Saver or Basic plans may be a good fit if you: Are relatively
Medicare Advantage HMO plans
2018 Medicare Advantage HMO plans Essence (HMO-POS) Essence Rx (HMO-POS) Esteem Rx (HMO-POS) Spirit (HMO-POS) Spirit Rx (HMO-POS) Medicare coverage that works with and for you Y0117_MC-778-2820-C-10-17
2019 Health Net Violet 1 (PPO) H5439: 011 Benton, Clackamas, Lane, Linn, Marion, Multnomah, Polk, Washington, and Yamhill Counties, OR; Clark County,
2019 Health Net Violet 1 (PPO) H5439: 011 Benton, Clackamas, Lane, Linn, Marion, Multnomah, Polk, Washington, and Yamhill Counties, OR; Clark County, WA H5439_19_8026SB_011_M Accepted 09072018 This booklet
Allwell 2019 Individual Enrollment Form
Allwell 2019 Individual Enrollment Form Please contact Allwell if you need information in another language or format (Braille). To enroll in Allwell, please provide the following information: Please check
<Logo> 2019 Allwell Medicare (HMO) H1664: 004 Crawford, Franklin, Jefferson, Lincoln, St. Charles, Warren, and Washington Counties, MO
2019 Allwell Medicare (HMO) H1664: 004 Crawford, Franklin, Jefferson, Lincoln, St. Charles, Warren, and Washington Counties, MO H1664_19_7896SB_004_M_Accepted 09082018 This booklet provides you
Tufts Medicare Preferred Supplement. IMportant information. PO Box 9178 Watertown, MA 02472
Tufts Medicare Preferred Supplement 2018 Enrollment Application PO Box 9178 Watertown, MA 02472 IMportant information Please read the Important Information section, fill out the application on page 1,
These are the Optional Supplemental Benefits you can buy.
These are the Optional Supplemental Benefits you can buy. If you are enrolled in Allwell Medicare, you have the choice to customize and enhance your coverage with optional supplemental benefits. For an
Annual Notice of Changes for 2019
BlueAdvantage Diamond (PPO) SM offered by BlueCross BlueShield of Tennessee Annual Notice of Changes for 2019 You are currently enrolled as a member of BlueAdvantage Diamond. Next year, there will be some
2019 Health Net Seniority Plus Green (HMO) H0562:045 Alameda, Placer, Sacramento and Stanislaus Counties, CA
2019 Health Net Seniority Plus Green (HMO) H0562:045 Alameda, Placer, Sacramento and Stanislaus Counties, CA H0562_19_7815SB_045_M_Accepted 09072018 1 This booklet provides you with a summary of what we
Health Net Medicare Advantage Plans 2019 Optional Benefit Individual Enrollment Form
Health Net Medicare Advantage Plans 2019 Optional Benefit Individual Enrollment Form Health Net offers optional benefits for an additional monthly plan premium. This form may be used only by our current
Summary of Benefits. Aetna Medicare Rx Costco Plus Plan (PDP) S5810. California. January 1, 2010 to December 31, 2010
January 1, 2010 to December 31, 2010 Summary of Benefits Aetna Medicare Rx S5810 California S5810_D_PE_SB_90712 (08/2009) Visit us www.aetnamedicare.com 1 Summary of Benefits: Aetna Medicare Rx Section
2011 Retiree Benefits News
2011 Retiree Benefits News For Legacy Schering-Plough Retirees October 2010 Welcome to the 2011 Annual Enrollment OCTOBER 22, 2010 NOVEMBER 12, 2010 Each year during the Annual Enrollment period, you have
2016 COPAY AND DEDUCTIBLE PLANS
2016 COPAY AND DEDUCTIBLE PLANS Health Insurance for Individuals & Families Welcome to PreferredOne PreferredOne.com Your Health, Your Choice, Many Options At PreferredOne, our name says it all you and
See Medical Benefit Summary See Medical Benefit Summary. See Medical Benefit Summary See Medical Benefit Summary. Up to 31-day supply
YOUR BENEFITS Benefit Summary Outpatient Prescription Drug Keller ISD High Deductible 2019 Pharmacy Plan This document is provided as a sample and does not reflect actual benefits. A customized Benefit
Farm Bureau Essential Rx 2018 Summary of Benefits January 1, December 31, 2018
Farm Bureau Health Plans P.O. Box 266380 Weston, FL 33326 Farm Bureau Essential Rx 2018 Summary of Benefits January 1, 2018 - December 31, 2018 Thank you for your interest in Farm Bureau Essential Rx.
Your Vision Website from Health Net
Your Vision Website from Health Net See it to believe it! Kim Aung Health Net Your Health Net of California, Inc. and Health Net Life Insurance Company (Health Net) vision member website offers detailed
INTRODUCTION TO SUMMARY OF BENEFITS
INTRODUCTION TO This booklet gives you a summary of what we cover and what you pay. It doesn't list every service that we cover or list every limitation or exclusion. To get a complete list of services
Summary Of Benefits January 1, December 31, 2019
Summary Of Benefits January 1, 2019 - December 31, 2019 Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association Care1st is an independent licensee of the
2018 Outline of Coverage McLaren Medicare Supplement Plans A, C, F, High Deductible-F, G & N
2018 Outline of Coverage McLaren Medicare Supplement Plans A, C, F, High Deductible-F, G & N McLarenHealthPlan.com/MedicareSupplement Call us toll-free (888) 327-0671, Monday - Friday from 8 a.m. 6 p.m.
Your Plan at a Glance
Your Plan at a Glance Summary of Medical Benefits This chart summarizes the benefits available under the Aetna/ Innovation Health Preferred Provider Plan, Open POS II medical plan: Plan Feature Annual
summary of benefits Blue Shield of California Medicare Rx Plan (PDP)
summary of benefits Blue Shield of California Medicare Rx Plan (PDP) An employer-sponsored Medicare Prescription Drug Plan for City and County of San Francisco retirees, spouses and eligible dependents
Allwell 2019 Individual Enrollment Form
Allwell 2019 Individual Enrollment Form Please contact Allwell if you need information in another language or format (Braille). To enroll in Allwell, please provide the following information: Please check
2018 Individual Enrollment Request Form
2018 Individual Enrollment Request Form If you have questions, please contact AgeWell New York at: 1-866-586-8044 or TTY 1-800-662-1220 Fax Enrollment form to 1-855-895-0784 Please contact AgeWell New
Summary of Benefits. Community Blue Medicare HMO. Western Pennsylvania. January 1, 2018 December 31, Service Area
Western Pennsylvania Community Blue Medicare HMO Summary of Benefits January 1, 2018 December 31, 2018 Service Area Our service area includes the following counties in Pennsylvania: Allegheny, Armstrong,
2018 Community Blue Medicare PPO Summary of Benefits
2018 Community Blue Medicare PPO Summary of Benefits Residents of the following counties: Allegheny, Beaver, Butler, Erie, Greene, Fayette, Washington, Westmoreland, please click here. Residents of the
Enrollment Request Form
Employer name: Coverage effective date: Employer group number (Medical): Important Please print all sections in black ink. For the application to be valid, you must submit all applicable pages. 1. Select
See Medical Benefit Summary See Medical Benefit Summary
Benefit Summary Outpatient Prescription Drug Products Oregon Plan I1 Standard Drugs: 15/30/50 Your Co-payment and/or Co-insurance is determined by the tier to which the Prescription Drug List (PDL) Management
Check Plan Type: Check Enrollment Type: Fill Out Sections: q KP/HSA Small Group Employee Enrollment Form q Multi-Choice
Kaiser Foundation Health Plan of Georgia, Inc. Kaiser Permanente Insurance Company (KPIC) Check Plan Type: Check Enrollment Type: Fill Out Sections: q KP/HSA q New Hire A, B, C, D q Added Choice/HSA Added
2018 Plan Year Monthly Plan Premium for People Who Get Extra Help From Medicare to Help Pay for Their Prescription Drug Costs
2018 Plan Year Monthly Plan for People Who Get Extra Help From Medicare to Help Pay for Their Prescription Drug Costs If you get extra help from Medicare to help pay for your Medicare prescription drug
Health First Gold HMO Coverage Period: On or after 01/01/2018
Health First Gold HMO 80 1770 Coverage Period: On or after 01/01/2018 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage for: Individual Only Plan Type:
Summary of Benefits. Allwell Dual Medicare (HMO SNP)
2018 Summary of Benefits Allwell Dual Medicare (HMO SNP) Abbeville, Allendale, Bamberg, Barnwell, Beaufort, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield,
LVAIC-Muhlenberg College: Lehigh Valley Flex Blue PPO Coverage Period: 01/01/ /31/2017
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.highmarkblueshield.com or by calling 1-800-345-3806.